FAQs on Degenerative Scoliosis in Nashville TN

Adult degenerative scoliosis is a type of spinal curvature that is the result of degeneration and arthritis of the spine. Typically staring after age 40, degenerative scoliosis affects around 7% of the adult population. Patients with this condition often experience back pain and discomfort, which progressively worsens as the curvature increases.

What are the symptoms of degenerative scoliosis?

Many patients with degenerative scoliosis have back pain and muscle fatigue, as well as occasional leg pain. With large curves of the spine, patients often have other signs and symptoms, such as leg length abnormalities, skin folding, and chest wall discomfort. Other symptoms include:

  • Poor sense of balance
  • Humpback
  • Irregular gait
  • Difficulty standing or sitting
  • Spinal rigidity and loss of mobility
  • Muscle weakness
  • Breathing problems
  • Unusual sensations of the legs, such as loss of sensation and tingling

What causes degenerative scoliosis?

With age, connective tissue and bones suffer wear and tear, and degeneration occurs. The spine takes on an abnormal, lateral curve. In addition, degenerative scoliosis occurs from chronic back conditions such as degenerative disc disease, spinal stenosis (spinal canal narrowing), compression fractures of the vertebrae, and osteoporosis.

How is degenerative scoliosis treated?

Treatment of degenerative scoliosis involves alleviating the various symptoms because not everyone with a curved spine has back pain. Treatment options include:

  • Pain medicine infusion – The doctor inserts a small catheter into the epidural space near the affected nerves. Medications are given through this catheter, such as anesthetics. When the nerves are blocked with infusion, pain relief is long-lasting. When a pain pump is implanted, the patient receives continues narcotic medication directly to the spinal nerves. This treatment has a 67% efficacy rate.
  • Transcutaneous electrical nerve stimulation (TENS) – With this technique, the patient uses a small device that is worn outside the body. A mild electric current is delivered to the skin via a wire and electrode. The electric impulses interfere with pain sensations to relieve discomfort.
  • Epidural steroid injection (ESI) – The doctor inserts a small catheter into the epidural space, which lies between the epidural tissue and spinal cord. A steroid agent is instilled, with or without an anesthetic. In a review of clinical studies, researchers reported success rates of 70-100% with ESI.
  • Physical therapy – The therapist teaches exercises and techniques to increase spinal flexibility, mobility, and strength. In addition, treatment involves massage, ultrasound therapy, and electrical stimulation.
  • Back brace – A brace will reduce spinal motion, provide support, and decrease pressure on supporting structures. The brace is only worn for a couple of hours each time starting out, and the patient gradually increases duration as tolerated.
  • Medications – Mild pain from scoliosis is treated with nonsteroidal anti-inflammatory drugs (NSAIDs), but other medications used include narcotic pain relievers, muscle relaxers, neurogenic agents, and topical agents.
  • Facet joint injection (FJI) – The facet joints are positioned between each vertebra, offering mobility and stability to the spine. FJIs are given in a series of three. In this procedure, the doctor positions tiny needles into the facet joint spaces under x-ray guidance. Once in position, a long-acting steroid and anesthetic agent is injected. Researchers found FJI 84% effective in a recent clinical study.

Resources

Barre L, Lutz GE, Southern D, & Cooper G (2004). Fluoroscopically guided caudal epidural steroid injections for lumbar spinal stenosis: a restrospective evaluation of long term efficacy. Pain Physician, 7(2), 187-193.

Birknes, JK, Harrop JS, White AP, et al. (2008). Adult degenerative scoliosis: a review. Neurosurgery, 63(3), 94-103.

Kobayashi T, Atsuta Y, Takemitsu M, Matsuno T, & Takeda N (2006). A prospective study of de novo scoliosis in a community based cohort. Spine, 31, 178–182.

Ploumis A, Transfledt EE, & Denis F (2007). Degenerative lumbar scoliosis associated with spinal stenosis. Spine Journal, 7, 428–436.

Shim JK, Moon JC, Yoon KB, Kim WO, & Yoon DM (2006). Ultrasound-guided lumbar medial-branch block: a clinical study with fluoroscopy control. Reg Anesth Pain Med, 31:451-454.